ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title No Evidence To Compare Polymerization Shrinkage And Sensitivity With Incremental-Fill vs. Bulk-Fill Composites
Clinical Question Do composites that are bulk-fill, such as SonicFill™, have excessive polymerization shrinkage causing sensitivity, when compared to incremental-fill composites?
Clinical Bottom Line At this time, there are no studies that have been conducted using a bulk-fill composite such as Sonicfill™ to test polymerization shrinkage or sensitivity. In general, when traditional composites are used in a bulk-fill fashion, they appear to have decreased hardness and increased amounts of polymerization shrinkage when compared to incremental-filling. Using data on the SonicFill™ website, there is nothing to suggest a unique category of polymerization shrinkage exists for it compared to older composites where polymerization shrinkage is significant when used in bulk-fill. The delivery method is unique, but there is no data to suggest that the shrinkage problems in the studies cited would be overcome by altering the delivery. More studies need to be conducted using the newer types of bulk-fill composites.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17692594Lazarchik/200770 recently extracted human molarsIn vitro Randomized Control Trial
Key resultsFor 3 multi-shaded materials tested, axial hardness values were relatively unaffected by composite resin shade or filler classification for the incremental technique, but were significantly affected by these factors when using the bulk-fill method. A single shade translucent material was not affected in either the bulk or incremental condition.
#2) 18433857Park/200815 aluminum blocks prepared for MOD restorationsComparative study of aluminum blocks
Key resultsThe bulk filling technique yielded significantly more cuspal deflection than the incremental filling techniques, while there was no significant difference between the horizontal and oblique increment methods.
Evidence Search "incremental and bulk filled technique" AND "composite"
Comments on
The Evidence
Neither study was performed in vivo and the second study was performed on aluminum blocks rather than actual teeth. Unfortunately, there is no evidence for composites developed to be used in a bulk-fill fashion.
Applicability The results from these studies are relevant when using more traditional composites.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords composite resin, incremental filling technique, bulk fill technique, polymerization shrinkage, sensitivity
ID# 2140
Date of submission: 09/16/2011spacer
E-mail normans@livemail.uthscsa.edu
Author Sarah Norman
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author David Cox, DDS
Faculty mentor/Co-author e-mail CoxD@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Juan Verastegui (San Antonio, TX) on 11/30/2017
A PubMed search in Nov. 2017, located a lab study that provides a more conclusive answer to the CAT clinical question, using extracted molars with MOD preparations. Rosatto et al. (PMID# 26449641) examined physical properties of bulk-fill composites compared to incremental filling composite techniques. Outcome measures also included shrinkage stress, cuspal strain and fracture resistance. Results indicate that bulk-fill composite techniques resulted in lower cusp strain, shrinkage stress and higher fracture resistance.
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